I have been a subscriber to Contagion Live since Covid-19 began spreading rapidly in the US. Contagion Live has updates on many contagious pathogens, but a majority of the content is devoted to Covid-10. In addition to articles from scientist across the world, Contagion Live has links to several other similar subscription services, many like Medscape are free. The reproduction rate for the Delta Variant may be as high as 7. This means you may have only two choices, get the vaccine or you will get the Delta Variant. One report said there was evidence that the Delta Variant may cause lung cells to fuse enabling the virus to spread rapidly cell to cell. This may result in permanent lung damage in younger folks. While deaths for patients under 30 are rare, long term lung damage is common. With a reproduction rate of 7 the dream of herd immunity happening this summer may be just that, a dream. The Covid-19 infection rates could see a rebound in late July after the 4th of July holiday weekend. https://www.contagionlive.com/view/cdc-updates-covid-19-delta-variant-to-one-of-concern-

Vermont had under 40 deaths per 100,000, while most rural states have had three times that number. Vermont is located between the early epicenters of the pandemic, Boston and New York. Midwest and southern states had time to prepare as the pandemic started on the coasts. Yet Vermont with a vulnerable elderly population, located between the epicenter of the pandemic with thousands of folks fleeing New York and Boston managed the Pandemic better than any other state.

In Wisconsin we had over 3 times the deaths per 100,000 folks. After comparing the the two states there are some huge contrasts. Wisconsin’s rural areas tend to be much more libertarian. At the county board meetings hundreds of folks spoke about their constitutional rights, the bill of rights and fear of the health officer. County board speakers expressed a fear of public health nurses imposing draconian measures limiting freedom. Noble Prize winning economist Milton Friedman, a champion of libertarian ideals, was clear that rights and freedoms ended with an epidemic where you could infect your neighbor. In these circumstances, you have an absolute obligation and responsibility to protect one another with every measure possible. Conservatives in Wisconsin made the debate all about personal rights and freedoms, making fighting a pandemic, not a policy and public health issue, but a cultural war with what they perceived as an assault on their liberty. When we turn a policy debate into a political debate, we all lose.

In contrast to Wisconsin, Republican Vermont Governor Phil Scott established a Covid-19 war room and pushed public health measures. Vermont, as opposed to its neighbor New Hampshire whose motto is “live free or die” chose not to live free and die. In Vermont you did not have an extreme form of libertarian revolt to Covid-19 public health measures and despite not having the warning time of Wisconsin or Florida had less than a third of the deaths. Vermont set up a Covid-19 war room. Vermont imposed strict reopening standards, which were accepted by it citizens. Vermont has reached 80% of its population having at least one vaccination. Vermont, by hitting Covid-19 public health benchmarks early, moved up reopening early. Vermont treated Covid-19 as a public health issue first relying on sound public health policy. Vermont did not have hundreds of folks attacking long time public health officials at a county board meeting.

Vermont’s economic outcome after Covid-19 is exceptional. Vermont has one of the two lowest unemployment rates in the nation. Vermont is flush with revenue taking advantage of Covid-19 federal government stimulus money and by controlling Covid-19 was able to keep tax revenues stable. As for a Republican Governor in a state with Bernie Sanders as Senator and where Biden won by 35 points, Phil Scott won his election by 40 points. The lesson of Covid-19 for all politicians two fold. First treat a pandemic or any other sudden catastrophic occurrence as a public policy issue, not a cultural issue and you will do well. Second, stop turning policy issues into political battles and you and your constituents will be better off.

Senator Ron Johnson’s has made several bizarre statements about Covid-19 Vaccines. The worst one is about people dying following vaccination. Yes if someone in vaccinated and gets killed in a car accident, that person died following vaccination, but the two are not related.

Senator Johnson has said young healthy folks need not be vaccinated. The Chinese physician that originally posted about the first Covid-19 outbreak was 34 and died from Covid-19. The problem with young healthy adults not getting vaccinated, is they are the folks that are most likely not to wear mask, then get the infection and have an asymptomatic case. These are the folks that become the silent super spreader. The Covid vaccine is 95% effective. In the original trials, 162 folks in the placebo group got infected while 8 in the vaccinated group were infected. These studies did not show folks dying from the vaccine.

Ron Johnson is an accountant. In the past he attacks others by questioning if they understand basic math. Epidemiology focuses on math in the form of a virus’s reproduction rate. If the reproduction rate is 3, as for the original Covid-19 virus, to achieve herd immunity requires 65 percent of folks to develop antibodies to the virus. This can happen through vaccination or prior infection. Since 5% of those who get vaccinated get the infection and many folks who had one infection gets reinfected, over 70% of folks need vaccinations. With the new variants having a reproduction rate of closer to 5 the number jumps to over 80% needing vaccination. If the vaccine is less effective against the variants, (lets say 65% effective) then over 90% of folks 12 and over need vaccination. Moderna just put out a paper indicating a third shot increases protection against the new variants.

Senator Ron Johnson has stated that since he has had the virus, he does not need to be vaccinated. There are ample cases of folks getting Covid-19 a second time. These second time patients will shed viruses when that happens. Senator Johnson is willing to risk infecting other folks when a simple shot can reduce the chance of that happening by 95%.

Senator Ron Johnson praised a physician for administering a anti-viral drug when other physicians refused to do so. The family got a court order to administer the drug. I watch a podcast from a researcher who studied corona virus for years. He began studying before SARS and MERS. He infected cultures of respiratory epithelial cells with the virus and study multiple therapeutics (new medicines) effect on the virus. Often therapeutics given in doses high enough to effect the virus, killed the respiratory cells. Covid-19 patients shed virus for 10 days, the first 4 days they are not symptomatic. Anti viral drugs are only effective early, and given after 10 days do nothing, except for someone who is immune compromised and their body does not contain the virus. The patient mentioned here was on a respirator. At that time an anti-viral drug would no longer help. Consequently, the big issue with therapeutics is unless you administer them before symptoms which would require massive testing of anyone who has contact with a Covid-19 patient, you are giving them late in the course of the infection. Basically, it is easier to prevent a fire than put one out. Senator Johnson is promoting Covid-19 treatment via therapeutics by his senate hearings. Relying on therapeutics is equivalent to needing to build 20 fire stations to put out fires where by preventing the fires you only need one in your town.

Bloomberg news posted an article which on what went wrong with our response to covid19 February3. Ironically, one of their big issues was the lack of a nationally coordinated effort. Much of the failure was states leaving efforts up to the local communities, which are highly fragmented. Our state Republicans want to end the mask mandate and leave it up to local government. That did not work in Kansas where a majority of the counties opted out of the state mandate. Those counties opting out saw an exponential growth in Covid19 as compared to those that did not. I occasionally read articles on three medical sites I subscribe to. All of them promote strong national and international approaches. I find it intolerable that state legislators do not do minimal background reading. If they did there should be no support for leaving Covid19 to local communities. When you talk about new variants a single passenger on a single flight from Europe, Brazil, and South Africa can transport a highly infectious virus and enter on bar and become a super spreader. A virus needs a new home every 10 days. The combination of strict masking and vaccines will control it. Relying on vaccines alone will double or triple the time it will take to control this vaccine. https://www.cdc.gov/mmwr/volumes/69/wr/mm6947e2.htm

Thursday’s Wall Street Journal reported three new viral strains and a very high reproduction rate. Please read this article. https://www.wsj.com/articles/shape-shifting-virus-threatens-cycles-of-illness-lockdowns-11611752410?mod=itp_wsj&mod=djemITP_h

Wisconsin State Republicans voted 1/27/21 to block Governor Evers Mask Mandate. I contacted a majority of Republican Senators and sent them a study of the Kansas State Mask Mandate that allowed counties to opt out. The Counties that opted out had a exponential growth in cases where the counties who did not opt out had a far slower growth rate. I also pointed out this weekend’s Wall Street Journal that ran article on the 3 emerging viral strains of Covid-19 that are far more infectious and are now appearing to be more deadly. I did an open records request for the Republican plan to combat these new viral strains. Senator Feyen’s office reported no related documents. What is worse States with Emergency orders are to receive an additional 49 million dollars in assistance that we may not get due to this vote.

In conversations with a manager at an Atlanta hospital, a state without a mask mandate, she stated they designated 40 beds to covid-19 this spring and now upped that to 81 beds with the holiday surge. I do not understand given the outcomes in Georgia and Kansas why a legislator would vote against a mask mandate. When we have states with ICU units overrun like Georgia and Texas, I would believe a legislator would do everything they could to combat this situation. One of the reasons two Republican Senators lost their elections in Georgia was the disgust with the lack of response to this virus.

A few days ago I saw a post on Facebook about the devastation to businesses like wedding venues, caterers, bars and restaurants in Wisconsin. The post said we should have been open like Texas and Florida. The Texas Covid Tracking Project has detailed information on Texas Hospitalization rates. October 1 had 3,190 patients hospitalized with 1075 on ventilators. By January 9 there were 13,935 reported hospitalized with 3,478 on ventilators. That means nearly 14,000 Texas residents will remember the 2020 holidays, not for family gatherings, but for praying that your loved one would be there for the next Christmas Holiday.
We need to help the person who wrote this post. I would like to see a more targeted Covid-19 relief package to help these folks. Activities that are super spreader events must be put on hold until 85% are vaccinated. Opening like Texas is not an option. I spoke with a friend in Atlanta who is a manager at a 150 bed hospital. They now have 81 beds designated for Covid-19. My friend in Atlanta is drained by double shifts, staff shortages, and seeing patients being diverted or not given a hospital bed as there are none left.
A relative who has two pensions, social security and did not spend money during Covid-19 by staying home said, give the relief to those who need it.

Viruses do not live long outside a host. So every 10-14 days the virus needs its host to spread the virus to another host. On average someone infected with Covid-19 infects 3-4 other folks. This is called the Reproduction Rate. To control a virus the Reproduction Rate needs to be less than one. The results of this exponential rate of infection can be seen in the county where I live. Winnebago County went from 1300 cases on September 1 to over 15,000 today one day from the New year.

Last Summer Kansas’s Governor issued a state wide mask mandate that most counties opted out of. A Study by Kansas State University showed that the counties that opted out of the mask mandate had twice the rate of growth in Covid-19 cases than those that did not opt out. Berkeley California has a strict mandate with enforcement. Berkeley has a death rate of 8 per 100,000 on the same date Winnebago County had a death rate of 80 per 100,000. Wisconsin has a mask mandate that has no enforcement. Taiwan has had less than 10 deaths with a strict mask mandate and a weekly mask allocation program of high quality masks, either N95 or multi layer surgical masks. My last dental visit the dentist was wearing a N95 mask with a surgical mask over the N95. This is a virus that spreads easily through air. Dentist work in aerosol filled environments, so Dentist are especially careful. This virus can be controlled with a strict mask mandate that has enforcement. The Kansas study showed we can easily reduce the infection rate by half in counties with a mask mandate. Asian countries, with massive public transportation and crowded cities, that are perfect for viral spread, were able to control the virus with high end masking. This has kept their economies open.

If everyone would properly wear a high quality mask, or double mask with less effective masks we could lower the Reproduction Rate below 1. The further below 1 we lower it the faster the virus goes away. If we mainly rely on a vaccine that is 95% effective, we have to have 85% of folks vaccinated. A person who is an asymptomatic spreader, normally spreads the virus to 4 others, If 3 of the 4 folks are vaccinated those 3 do not get the virus, and now only one other person gets infected. Occasionally, all four of the folks are vaccinated, then the chain of spread is broken, the virus dies out. If we add strict masking to this equation once we hit 85%, with everyone wearing a mask, the spread is further cut in half or more, then the virus fails to find a new host a majority of the time, the virus dies out quickly. Until the United States has no new cases for several days, strict masking should be followed.

Kristen V Brown writes, that Researchers at Standford University and Northwestern University used data collected between March and May in cities across the US to map the movement of people. Their Study was published Tuesday in the journal “Nature”. They found that 10% of the locations examined accounted for 85% of predicted infections. Capping occupancy at 20% in Chicago Metro area cut infections by 80%.

https://www.bloomberg.com/search?query=covid%20superspreaders&sref=FP7n92xs

Wisconsin has a restaurant occupancy limit of 25% back in effect after several court actions. Most restaurants cannot financially survive at this occupancy. I believe it is more important to provide financial assistance to these local businesses instead of sending more money to Foxconn whose buildings are being used for winter boat storage. To rebuild the Wisconsin economy, from the effects of the Pandemic, we need to redirect resources to training skilled trades to replace retiring Baby Boomers, make sure that 90% of folks get the Covid19 Vaccine so retirees feel safe in restaurants, and give aid to closed business until at least a 80% vaccination rate is reached. Since restaurants have been the source of many super spreader events, the Tavern League, Chamber of Commerce and Restaurant owners need to push vaccinations.

There is a lot of misinformation and a lot of intentional disinformation about Herd Immunity. Sweden is conducting a national experiment in Herd Immunity. The Idea is that if enough people catch Covid-19 early, it will prevent a second wave. Sweden has had 5 times the per capital deaths of Denmark and 10 times the rate of Norway and Finland. Yesterday Sweden quietly changed directions allowing local lock-downs. The jury is still out on this approach. If Wisconsin had the same per capital deaths of Sweden 1900 more would have lost their lives. That means 1900 more times an ICU nurse would have zipped a body bag and informed families that their loved ones died. The infection rate is going up, but as medical communities develop better treatment, the death rate is declining. There are medications being tested that may be available in several months. We will not know the long term effects of Covid-19 for those with mild cases, but there appears to be lung, heart, and kidney damage in some patients. What is more troubling is there is a lot of disinformation being put out by Russian Trolls aimed at polarizing our great nation, and folks on the far right and left re-posting this disinformation. Please research your sources and do not support the efforts of the Russian Cyber Warfare division of the Russian Military.

Three Epidemiologist put out the “Great Barrington Declaration”. They are advocating in letting Covid-19 run its course in younger patients to achieve herd immunity. There are several issues with this. This herd immunity approach has been call a fallacy by a group of 80 researchers according Contagion Live publications. Some are claiming that herd immunity could be achieved with just 20% of the population being infected. Herd immunity for a virus with a reproduction rate of over 3 is more likely 70%. Since the long term effects of this virus on heart, lung and kidneys is not know, wearing masks avoiding indoor spaces with non-family members, until a vaccine is available seems prudent. Getting herd immunity where up to half of those with the virus have long term organ damage, goes beyond stupid. Too much is still unknown to advocate for this course of action.

Taiwan and New Zealand still remain the gold standard for controlling Covid-19. Taiwan has a weekly allocation of N-95 or 3-layer surgical masks. Taiwan has had less that 10 deaths in 7 months. In New Zealand President Jacinda Ardern won by a landslide in the October 18 election. Her motto for coronal virus of “Go Hard and Go Early” has controlled outbreaks with a hard early lock-down. New Zealand had gone for over 100 days without infections, before they had a new cluster outbreak, which they controlled. The most frustrating aspect of this virus is that we are seeing rural areas of Wisconsin and the Dakotas, which avoided the virus, now leading the country in outbreaks. These are areas where the president has great followings, and had plenty of time to put robust prevention protocols in place. However, they ignored the advise of the medical community as the president ridiculed many of the precautions that countries like Taiwan took. We know how to control this virus, just do it.